Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease.
Overview
9
9
years of professional experience
Work History
Senior Claims Technician
HCSC
01.2021 - Current
Processing complex paper, and electronic submitted Texas, and Illinois claims that require further investigation using the Blue Card System and Claims GUI System, to resolve pended claims and processing adjustments
Using appropriate cost containment techniques including strategic vender partnerships to reduce overall cost of claims for our clients.
Contributed ideas for continuous improvement initiatives within the department that led to increased productivity levels.
Managed high volume of daily claims while maintaining attention to detail and superior customer service standards.
Coordinated with outside vendors such as appraisers or adjusters for timely completion of necessary evaluations or assessments related to claims handling process.
Evaluated complex claims situations, providing expert guidance to support informed decision-making processes.
Modified, updated and processed existing policies.
Reviewed outstanding requests and redirected workloads to complete projects on time.
Operations Assistant
Community Healthcare System
12.2018 - 01.2021
Provide secretarial and clerical support to managerial and department head associates, and Audiologist, Physical, Occupational, and Speech Therapist
Using EPIC system for appointment scheduling, preparing correspondence, updating patient records, and training new employees.
Solved problems timely and effectively, ensuring customer satisfaction.
Managed day-to-day department operations with effective workflow coordination.
Supported daily operations by organizing office spaces for maximum functionality and ease of use.
Planned and coordinated logistics and materials for board meetings, committee meetings, and staff events.
Central Scheduler
Franciscan Physician Network
12.2014 - 12.2018
Answer multiple lines from patients requiring medical services and make outbound calls to schedule/reschedule doctor appointments using EPIC/AllScripts software
Filing, Faxing, reading, monitoring, and responding to emails
Used electronic systems to enter provider orders and retrieve test results.
Coordinated multi-disciplinary team meetings involving various healthcare professionals from different departments or facilities to ensure seamless care delivery.
Scheduled patients for tests and consultations.
Followed up with patients to reschedule missed appointments.
Verified insurance coverage and eligibility for medical services prior to scheduling appointments to prevent billing issues.
Education
Associates of Business and Healthcare Administration -
Strayer University
Chicago, IL
03.2024
Timeline
Senior Claims Technician
HCSC
01.2021 - Current
Operations Assistant
Community Healthcare System
12.2018 - 01.2021
Central Scheduler
Franciscan Physician Network
12.2014 - 12.2018
Associates of Business and Healthcare Administration -